Thursday, 21 February 2019

Why is it that those with active schizophrenic psychosis - in the early 'delusional mood/atmosphere' stage - tend to delusionally experience visible buildings as stage sets - as mere façades?

Thomas Fuchs provides a partial answer in his 2005 paper on delusional mood and delusional perception:

In delusional mood, the environment as perceived by the patient changes into a puzzling, mysterious and stage-like scenery. ... Husserl’s concept of intentional perception ... tells us how perception overcomes its own perspectivity [and] may also be understood as describing the intersubjective constitution of reality through common concepts which structure intentional perception: we see a table because we can name it a table as well. ... With the weakening of intentional perception in schizophrenia, objects and situations are not perceived as such any more, but as mere images or enigmatic sceneries. They lose their common-sense significance and turn into a ubiquitous puzzle. Strictly speaking, the significances may still be known in an abstract way, but they have stopped to mean anything to the patient. He is not able to relate them to a common intersubjective world any more.

Henriksen & Parnas also give something of an answer in their 2019 paper on delusional mood:

In delusional mood, the world appears strangely, yet indefinably different. Events or objects lose their natural sense of familiarity, purposefulness, and coherence, and the world itself becomes increasingly uncanny (“unheimlich,” literally meaning “non-homely”)—that is, the patient no longer feels at home or at ease in the world. ... In delusional mood, the context’s mutually implicative referential functions are somehow loosened or weakened, decontextualizing singular perceptual elements from their ordinary, contextual embeddedness and enabling new, unfamiliar meanings to emerge alongside the familiar ones (cf. Matussek 1987: 90). For example, the casual look of a stranger in the street or the tone of voice of a waitress could indicate that they “know” what is going on; the manufacturer’s print on the coffee mug could be a sign pointing to the nature of the impending, etc. Eventually, the patient may experience that objects, events, or others, as Fuchs puts it, no longer “present” themselves in the phenomenological sense of the term, but “only pretend to be just themselves” (Fuchs 2005: 136; author’s italics), leaving an impression of a strange,unreal, artificial, or staged world—a typical form of derealization in schizophrenia...

I'd like to supplement these with the answer given by Morag Coate in her 1964 autobiographical Beyond All Reason. Coate's philosophy of perception is enmeshed in misleading, non-phenomenological, merely empiricist/Cartesian/Kantian assumptions. Nevertheless her lived experience shines through, as do the possibilities of its phenomenological re-theorisation:

We take for granted the knowledge of the spaciousness and distinctness of our surroundings. But at first, all we knew of space was what our limbs could reach. Sense data from our moving limbs, received and co-ordinated in the brain, gave us a three-dimensional map of our immediate environment; to this was added information interpreted with growing skill from a pattern of sense impressions received on the small curved surface of each retina. ...I have plenty of evidence that the room in which I write this is a real room. My view of it makes it possible for me to touch at will the various objects in it; my friends find it as real as I do myself. The fact remains that the room I see is an image projected in my own inner imagination. The image is based on externally received sense impressions, but an image it remains. ...The space I see now extends only as far as the surface of the walls of my room, except where the windows give me a view of houses opposite and of sky beyond. This is the limit of the environment that I can derive from my senses; the rest is built up in imagination. I am aware beyond the wallpaper of the thickness of walls, and beyond them of other rooms whose known contents I can visualise. The houses opposite have rooms in them whose contents I do not know, though I can vaguely picture them. Beyond this street there is the wide extent of the city in which I live. Beyond the seen expanse of sky is the earth's atmosphere, and outer space, and a myriad unseen stars.This imagined, though not imaginary, world is quickly altered or even disintegrated by illness. Suppose I suddenly become psychotic while writing this. I can now look across at the houses opposite and see that they are no more than a façade; beyond them is nothingness, and anyone who goes through their front doors will walk into oblivion. And if I go out of my room and walk downstairs I shall enter a different atmosphere which now envelops the earth's surface to a height of ten feet and has the effect of producing complete loss of memory. If at this point the tenant of the downstairs flat arrives to borrow a shilling for her gas meter, I shall be aware that an unseen spirit has entered into her and protected her from harm, and further that my shilling when put into her downstairs meter will affect the quality of the flame from her gas stove and so start regenerating the atmosphere down below.I have invented this on the spur of the moment. I do not believe a word of it. That is because the imagined framework of my reality environment, based on past experience of life, is still intact. It is important to remember that we have no factual evidence for the vast proportion of what we know; once we have learnt to interpret the more usual phenomena of life we arrive at conclusions by leaping from one piece of evidence to another, and our mental faculty for doing this with reasonable accuracy enables us to lead a normal life. I have never in fact seen or touched the back walls of the houses opposite, and have never enquired from anyone else whether such walls exist. And if they did, I cannot prove that they have not suddenly disappeared. I simply take it for granted that they are there. I have built them into my mental organisation, and so long as this remains intact they can only be demolished by rational means.In psychotic illness of the kind I have experienced, sense impressions are received clearly and with unusual vividness, but the mental organisation behind them and the critical faculty which sorts and examines and integrates internal ideas with external sense data is no longer functioning normally.

Friday, 8 February 2019

In a recent paper in Philosophy John Cottingham writes beautifully about the significance, for our ethical relations with others, of our animal responsivity to their suffering. We may be tempted by disengaged rationalistic schemas - of maximising our ethical utility by 'targeted altruism', and so on. But what such approaches ignore is that, whilst our ethical life cannot be reduced to our visceral compassion, it's also not extrinsic or merely externally related to it. What it is to be a good person is in part to be open to being moved by true pity in the face of another's suffering. Such emotionally alive pity isn't just some unfortunate, all-too-human, bias to be ironed out by some more rational goodness-maximising strategy; it's the very stuff of morality itself.

Having drawn our attention to the significance of such facts about human nature for the very meaning of a truly ethical response, Cottingham goes on, whilst discussing a passage of Simone Weil, to say that "it seems absurd to talk of grounding the requirement to be merciful in the way the world actually is... For it seems very doubtful that an appeal to our biologically and culturally evolved nature can generate the right kind of what today’s philosophers call normativity. In other words the question is whether human nature can imbue the value of loving kindness and mercy with the requisite moral authority to serve as an overriding principle of action." Since our nature is a congerie of good and selfish elements, "there seems nothing to entitle one particular set of instincts or desires to take normative precedence [... to have a "supreme normative force"... ] over the others". And, in discussing what's wrong with a Kantian approach, he writes "that there seems no contradiction, whether conceptually or in the will, in someone’s refusing to allow that the need or suffering of others is a reason to reach out to them in love and compassion."

The Good Samaritan - Hodler

In place of the naturalistic and Kantian schemes he rejects, Cottingham offers a Christian alternative: moral normativity derives from or is grounded in God's command to love our neighbour. He acknowledges that the truth of the Christian vision is not something which can be assessed by means of "‘spectator evidence’ – i.e. not with evidence of a kind that is accessible to any rational and impartial observer." Instead it's in "our deep responses of mercy, in our intuitive acknowledgement of the normative requirement to love our fellow humans – however much we may fall short, and however defiantly we may try to turn in the other direction – [that] we sense something beyond ourselves that commands our allegiance whether we like it or not (unless of course, we manage, to find a way of deflating these responses, as mere illusions). So our picture of the cosmos, or of ultimate reality, if it is to be a vision we can embrace with integrity, must be such as to support those intuitions."

I've a vast amount of sympathy for Cottingham's Christian vision of the centrality of love in its conception of the ethical life, and am also persuaded by his rejection of Kantian and utilitarian ethics. But I find myself dissatisfied by his question - the question which he answers by invoking the Christian God's commandment. The question is something like: "Why should we do the right thing?" "Why should we be guided by these rather than those instincts?" "Why should "the need or suffering of others" be "reason to reach out to them in love and compassion"?" And what I think is that the asking of such questions involves 'forgetting', in the way that only philosophers can 'forget', what it means to play an ethical language game and to live an ethical life. For the 'answer', I suggest, to the above questions, if we are even to allow them, is simply: "Because it's the right thing", "Because those are the morally good instincts", "The suffering of others just iswhat counts as reason here to reach out to them in love and compassion".

It's easy for me to imagine someone's exasperated reply to my 'answer': "But what I'm trying to inquire into is what makes this the right thing! You, sir, are simply refusing to play the philosophical game. Which is perhaps fine, but it's not ok to mistake your refusal to play for a move within the game!" But here I want to remind us of Wittgenstein's discussions of rule following and necessity. Many of the questions Wittgenstein looks at are ones he wants to reply to with a 'nothing' or a 'this is simply what we do' or a 'well, that's just what's called...'. For example, the philosopher wants to know what makes it the case that it's right to say '2+2=4' and not '2+2=5'. Wittgenstein rejects those Platonist and Conventionalist answers which say that 'the superstructure of the world' or 'how people tend to go on in practice' give the answer to the question. Instead he says simply "well, this just is how we do here go on; 4 just is what it is to add 2 to 2; 4 just is what we call 'the product of 2 and 2'. These are the rules..." It's precisely because the relations tracked here are internal that the 'what makes it the case that...?' question is out of line. Nothing 'makes it the case'. Just as when Bernard Williams, asked whether he was right to save the life of his wife or that of a stranger who had fallen off a boat, replied that to even attempt to justify the former would be to have 'one thought too many', so too do we have 'one thought too many' if we attempt justification where instead (depending on the context) either action or a reminder of what we mean by 'good' is required.

'These natural inclinations are the ones we call 'moral''. Which is to say: here there's no question as to whether we're right to call these and not those ones morally good. That just is what they're called.

At the end of all of this - and moving now away from Cottingham's paper - do we still have a place or need for talk of God in relation to our ethical life? Well, if you thought that the reason to believe in God was to make sense of our moral life, then you probably shouldn't believe. But, as I see it, such a form of theism which primarily invokes God to help us make sense of what we can apprehend non-theologically, this particular attempted invocation of 'reasons to believe', is itself another instance of the 'one thought too many' problem. "Why believe (what's the point of believing) in God?" ... There are plenty of good reasons internal to the Christian faith: 'Because he loves you, gave life to you, etc!' But 'how does believing serve your own other projects of comprehension?' - well, that's just not going to cut the theological mustard.